Avoidant Personality Disorder
What is avoidant personality disorder?
Avoidant personality disorder is one of a group of conditions called anxious personality disorders, which are marked by feelings of nervousness and fear. People with avoidant personality disorder have poor self-esteem. They also have an intense fear of rejection and being negatively judged by others. These feelings make them very uncomfortable in social situations, leading them to avoid group activities and contact with others.
What are the symptoms of avoidant personality disorder?
For people with this disorder, the fear of rejection is so strong that they choose isolation rather than risk being rejected in a relationship. The pattern of behavior in people with this disorder can vary from mild to extreme. In addition to their fear of humiliation and rejection, other common traits of people with this disorder include the following:
- They are oversensitive and easily hurt by criticism or disapproval.
- They have no close friends and are reluctant to become involved with others.
- They experience extreme anxiety (nervousness) and fear in social settings and in relationships, leading them to avoid activities or jobs that involve being with others.
- They tend to be shy, awkward, and self-conscious in social situations due to a fear of doing something wrong or being embarrassed.
- They tend to exaggerate potential problems.
- They seldom try anything new or take chances.
- They have a poor self-image, seeing themselves as inadequate and unappealing.
What causes avoidant personality disorder?
The exact cause of avoidant personality disorder is not known. However, it is believed that both genetics and environment play a role. The fact that avoidant personality disorder occurs more often in certain families suggests that a tendency to develop the disorder might be passed on in families through their genes. The disorder itself is likely triggered by environmental influences such as parental or peer rejection, which can impact a person’s self-esteem and sense of worth.
How common is avoidant personality disorder?
It is estimated that about 2.5 percent of the population has avoidant personality disorder. It appears to affect men and women equally. It generally begins in infancy and childhood and continues into adulthood. As with most personality disorders, avoidant personality disorder usually is not diagnosed in people younger than 18 years of age.
How is avoidant personality disorder diagnosed?
If symptoms are present, the doctor will begin an evaluation by performing a complete medical history and physical examination. Although there are no laboratory tests to specifically diagnose personality disorders, the doctor might use various diagnostic tests to rule out physical illness as the cause of the symptoms.
If the doctor finds no physical reason for the symptoms, he or she might refer the person to a psychiatrist or psychologist, health care professionals who are specially trained to diagnose and treat mental illnesses. Psychiatrists and psychologists use specially designed interview and assessment tools to evaluate a person for a personality disorder.
How is avoidant personality disorder treated?
Treating personality disorders is difficult, because people with these disorders have deep-rooted patterns of thinking and behavior that have existed for many years. However, people with avoidant personality disorder tend to be good candidates for treatment because their disorder causes them significant distress, and most want to develop relationships. This desire can be a motivating factor for people with avoidant personality disorder to follow their treatment plans.
As with other personality disorders, psychotherapy is the main treatment for avoidant personality disorder. Psychotherapy is the treatment of choice for antisocial personality disorder. Psychotherapy is a type of individual counseling that focuses on changing a person’s thinking (cognitive therapy) and behavior (behavioral therapy). Therapy is likely to focus on overcoming fears, changing thought processes and behaviors, and helping the person better cope with social situations. Medication—such as an antidepressant or anti-anxiety drug—might be used to help manage the anxiety felt by people with this disorder. For the best results, however, medication therapy should be done in combination with psychotherapy. Treatment for people with this disorder is most effective when family members are involved and supportive.
What are the complications of avoidant personality disorder?
Without treatment, a person with this disorder can become isolated from society, causing long-term difficulties with work and social functioning. They are also at greater risk for depression and substance abuse.
What is the outlook for people with avoidant personality disorder?
As with other personality disorders, treatment for avoidant personality disorder is a long process. The willingness of the individual to seek and stay with treatment can have an effect on treatment success and, therefore, the outlook. With treatment, some people with avoidant personality disorder can learn to relate to others more appropriately.
Can avoidant personality disorder be prevented?
Although it might not be possible to prevent this disorder, it might be helpful to begin treatment in people as soon as they begin to have symptoms.
- American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA, American Psychiatric Association, 2013. Accessed 3/3/2014.
- Skodol, A. E., & Gunderson, J. G. (2005). Personality disorders. In R. E. Hales & S. L. Yudofsky (Eds.), American Psychiatric Publishing textbook of personality disorders (pp. 821-860). Washington DC: American Psychiatric Publishing.
- National Institute of Mental Health (NIMH). Social Phobia (Social Anxiety Disorder): Always Embarrassed Accessed 3/4/2014.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 3/3/2014…#9761